Case Study: Fear of Highway Driving

46 year old mother has panic attacks when driving on highways, tunnels, and bridges. Systematic desensitization was used to treat the client in two sessions.

Presenting Problem

Becky had been driving for approximately 30 years and had never been in a car accident or traumatic experience involving cars, highways, or driving. She is a mother of 5, spiritual, and is constantly on the move going from one place to the next while also running a business from home. However, one day Becky developed a fear of driving on highways, over bridges, and through tunnels. While driving, the pressures of trucks bearing down behind her, people speeding, and the idea of going over a bridge or tunnel became a looming sense of dread. Becky had seen my name in a paper and decided to give hypnotherapy a try. Her goals were simple: be able to feel as comfortable on the highway as she did on streets around her neighborhood.

Background

A couple of years ago, she and her husband decided to sell one of their two houses, which ended up being an additional stressor in her life. During the period of selling her house, Becky would have to drive between the two houses which entailed a good amount of highway driving and over bridges. Having been able to suppress her anxiousness for a while, everything came to a head one day while driving with her husband. Distraught, Becky pulled to the side of the road in order to have her husband drive. Although Becky has been able to drive on the highway, it’s an extremely unpleasant situation and resulted in a fear of highway driving, as well as, a fear of going over bridges and tunnels. The idea of driving became a feeling of doom resulting in an increased heart rate, tension in her shoulders, and overall sense of dread. Certain things, such as talking to her friend on her phone while in the car would help, but nothing Becky tried helped to alleviate her symptoms completely. Her fear caused her to find longer routes to the destinations she and her family would drive to in order to avoid long stretches of highways or bridges and tunnels. She would constantly try to avoid having to carpool with other families in the area, in fear that she would have to drive on the highway. Her fear was starting to adversely affect her life even though she consciously knew that she was a safe driver.

Why this has occurred

During the period of selling her two houses, Becky was experiencing an excessive amount of stress. Driving between the two houses was an added amount of responsibility that in turn took its toll on her via an anxiety attack while driving with her husband.

Its important to note that when the body is dealing with things that cause us worry or feelings of insecurity, our primitive minds turn on the fight or flight response. However, in modern day society those reactions are typically inappropriate and we therefore, have created alternative methods for dealing with these emotions. Thus, resulting in stress, anxiety, and depression. These emotions when not given release mechanisms can turn inward on the body causing undiagnosable pain in various parts of the body. Pains that we call Body Syndromes.

When Becky was asked about her anxiety regarding driving, and where she felt tense, she stated that she could feel her shoulders tensing up, palms sweating, and heart rate increasing. When Becky stated that she had tension in her shoulders, she also noted that after driving on the highway or stopping thinking about driving on the highway, this tension dissipated. This particular body syndrome of the shoulders relates directly to the idea of excessive responsibility.

Bridges for Becky meant increased anticipatory anxiety. The feeling of driving on a bridge felt similar to an oncoming anxiety attack. When described the process as driving upward toward something you cant see and that as she drove up to where the bridge plateaued it was like increasing her anxiety level tenfold. Tunnels were also particularly hard for Becky. The idea of pulling into a two lane tunnel, feeling as if the tunnel could go on forever, and feeling the person behind her gave Becky an added sense of dread. Even looking in her rearview mirror made her anxious.

Once Becky had finally come to terms with the fact she had a fear of highway driving, she had a discussion with her mother about it who told Becky that she had the same fear. Her mother, as she later realized, had never been the driver in the family. Her father was the one consistently driving the family around. This admission from her mother made Becky realize that she no longer wanted to have this irrational fear and dread of highway anxiety. This is what led Becky into my office.

Method of treatment

In our first session, it was important for Becky to set a clear goal about what she wanted to accomplish. For her it was being able to drive on the highway, over bridges, and through tunnels without the feeling of dread. Her motivations included being able to drive to her college reunion, being able to drive her children around, and imagining being able to drive on highways to amazing places on her family vacations without having to take the backroads in order to avoid tunnels and bridges. She no longer wanted to have this irrational fear control her.

Having set the end goal and motivations, we discussed what her idea of relaxation is. For Becky, it was being on a beach right at sunset. This visualization for her was an extremely important part of her therapy. By having Becky visualize herself on the beach, feeling the sand between her toes, the smell of the fresh ocean air, the sound of the waves crashing onto the beach, and the amazing views and colors that accompany sunset, we were able to reinforce the feeling and idea of what relaxation feels like, looks like, smells like, etc. We determined how she feels about highway driving now, and how she would like to feel.

Before placing Becky into the hypnotic sleep, she was asked “in an ideal situation, how would you like to go about driving on a highways?”

Her answer was this:

Get into the car put on my seatbelt

If my children are in the car I just want to be able to listen to them and enjoy their company

Pull out of the driveway into the street feeling calm and relaxed

Drive to the highway

As I pull on the ramp, I want to feel calm and comfortable as I increase speed

To be unsuggestible people who are speeding and trucks that are passing me

To continue to drive feeling calm and relaxed and excited about where we are going and who we are seeing when we get to our location

Becky was placed into a state of deep relaxation and asked to build the visualization of being on her favorite beach. Each of the five senses of being on the beach were tapped into causing Becky’s entire body to relax despite her nervousness prior to entering the hypnotic sleep. As she built this visualization in her mind, noticeable releases of tension were noted through physical relaxation in her body, deep relaxing sighs, and a noticeable lowering of her shoulders.

With Becky in a deep state of relaxation that was tied to a place that incorporated all of her senses, the process of systematically desensitizing her to highway driving was done through her step-by-step process outlined about. As Becky was asked to get into the car, the moment she placed her hands on the steering wheel she was asked to feel the same relaxation she felt on the beach. The suggestion that each time she put her hands on the steering wheel, she would feel a deep relaxation state of being in control. Becky is a spiritual person and believed deeply in her guardian angle. While she was backing out of the driveway in her visualization, she was asked to feel a sense of comfort and safety knowing that her guardian angel was there with her. Additional positive affirmations, ones that Becky had told me prior to hypnosis, were given to her while she was visualizing driving. Affirmations such as ‘you are a good driver’ and ‘you have been driving for 30 years’ were given to her as well to increase her confidence as she drove down the side streets toward the highway.

When Becky was asked to imagine that she was pulling onto the highway she had what was called an abreaction. Abreactions are movements of the body while in the hypnotic state indicating that the client is sensing something that is making them uncomfortable. Each person can exhibit different reactions. Becky started to have increased breathing and a noticeable tension presented itself in her shoulders. When increase tensions arise, the client was asked to go back to the state of relaxation by visualizing or imagining being on the beach. As Becky allowed herself to go back to the state of relaxation, we also incorporated an anchor that would allow Becky to have an added tool in helping her deal with any residual tensions in the following days. While in hypnosis, Becky was given the tool that when she felt the dread of highway driving starting, she would simply place both hands on the wheel, take a series of deep breaths and begin to think about being back on the beach. Special attention was given herself permission to relax her shoulders.

Simply being able to bring up feelings of anxiety, visualizing driving opens a doorway or having a client visualize what it feels like to also be relaxed while driving. The two conflicting emotions cannot coexist together. Thus, feeling calm and relaxed is a much more pleasing state of being to a person then a state of anxiety. Through this practice of desensitizing Becky to each step in the process of overcoming highway driving, she was able to replace her fear with one of relaxation. These new associations where made stronger each and every time Becky utilized her tool of placing her hand on the wheel and taking in a deep breath and saying ‘thank you subconscious for alerting me that something feels wrong, but now I am in control and can take it from here.’

An additional part of the treatment plan was allowing Becky to know that if this feeling of anxiety were to present itself, that she had options. When a client is able to know that there are options to help alleviate the symptoms an increased sense of motivation can occur. Becky had dictated a list of these options to me prior to putting her into the hypnotic sleep and was given back to her while in the hypnotic sleep. Simply stating that if she felt anxious, she had the option of turning on music, calling her friends, or simply just partaking in a conversation in the car would also help to allow her to become more relaxed and de-focus on the feeling of anxiety. However, it was also important to allow Becky that as of the first session, she would no longer be suggestible to dread of highway driving. Because ‘today, she chose a new path of life’.

In our second session, we worked more directly on eliminating the dread that accompanied bridges and tunnels. Since her last session, Becky had driven on the highway twice and felt a great deal of relief. She noted specifically that when she was getting anxious she would use her tools and immediately feel her shoulders release.

Desensitization to bridges and tunnels would be done in a very similar fashion from our first session. Becky was asked to describe the process of what driving over a through a tunnel was like and how she wanted to feel. Each step of the process was done replacing any fear with a deep state of relaxation that was brought on in the first part of the hypnotic sleep. Becky was given the suggestion that as she accelerated on the bridge going up (the worst part of driving on a bridge for her) to imagine that as she pressed the gas peddle she could imagine she was pressing her foot into the sand and she could feel the sand beneath her feet. Upon approaching the top of the bridge, Becky had stated that she wanted to be excited of the amazing view from there and that the remaining portion of the bridge would be simply “gliding down” as she descended back onto the highway. The suggestion that the bridge was simply a connector between two places was also given.

For driving through tunnels, Becky was reassured as she entered the tunnel, that the tunnel would end. It was simply a matter of staying calm, relaxed, in control, and unsuggestible to the person driving behind her, which was something that increased her anxiety. She was worried that she wasn’t driving fast enough and the person would then tailgate too close causing her to look in her rearview mirror and stress. While in the tunnel, similar suggestions of feeling relaxed and visualizing the beach were given, her tools of hands on the wheel and feeling in control were reinforced, and moment in the tunnel would soon be over and she would be one step closer to reaching her exciting destination.

Outcome

After our first session Becky felt immediate relief and was able to drive on the highway without bringing up the feelings of dread. Our second session aided in further reinforcing the new associations and now Becky is back driving on the highway of life.